<html>
	<body>
			<form name="ragister" id="myForm" method="post" action="insert.php">
			<table align="left" width="100%">
				<tr>
					<th colspan="2"><h3>Insert New Record</h3></th>
				</tr>
				<tr>
					<td>Name</td>
					<td><input type="text" name="name" id="name"] placeholder="Your Name" required/></td>
				</tr>
				<tr>
					<td>Email</td>
					<td><input type="email" name="email" id="email" placeholder="Email" required/></td>
				</tr>
				<tr>
					<td>Mobile</td>
					<td><input type="tel" name="mobile" id="mobile" placeholder="Mobile Number" required/></td>
				</tr>
				<tr>
					<td>Gender</td>
					<td><input type="radio" name="gender" id="gender" value="Male" />Male<input type="radio" name="gender" id="gender" value="Female" />Female</td>
				</tr>
				<tr>
					<td colspan="2">
					 <!-- Captcha Start
<img src="captcha/captcha.php" id="captcha" /><br/>
<a href="javascript:void(0)" onclick="    document.getElementById('captcha').src='captcha/captcha.php?'+Math.random();
    document.getElementById('captcha-form').focus();"
    id="change-image">Not readable? Change text.</a><br/><br/>
<input type="text" placeholder="Security Code" required name="secretword" id="captcha-form" /><br/>
Captcha End--> 

					</td>
				</tr>
				<tr>
					<td colspan="2" align="center"><button id="submit" value="submit">Submit</button></td>
				</tr>
			</table>
			</form>
			</body>
			<script type="text/javascript" src="js/my.js"></script>
			</html>